By the end of this course, for each upper GI tumour site (oesophagusl, gastroesophageal junction, stomach, biliar tract, hepatocellular carcinoma, pancreas), participants should be able to practice:
• Proper indication for radiation therapy in a multidisciplinary perspective
• Appropriate prescription
• Tailored delineation according to tumour location and stage
• Dose distribution optimisation and comparison
• Optimal use of available IGRT technologies
• Proper monitoring of tumour response and control.
Session 1: Toracic Esophagus
Lectures on imaging based staging and state of art of pathological anatomy, surgery, medical oncology, clinical indications to radiation oncology, technical issues of radiation oncology will be provided.
Session 2: Gastro-esophageal junction (GEJ)
Lectures on state of art of pathological anatomy, molecular issues and physiopathology; imaging based staging and radiological anatomy; principles of delineation for the most relevant nodal regions related to GEJ presentations; will be provided.
Session 3: Delineation (FALCON session) + Video description of surgical procedure
Small group activity will be addressed. A tutored small working group target delineation and lymph-nodal areas contouring exercise for a clinical case will be performed. A video on surgical procedure highlighting the key surgical steps to have a better understanding of the local anatomy will be commented on by a surgeon. Each participant will attend both the small group activity
Session 4: Gastro-esophageal junction
Lectures on state of art of surgery, medical oncology, clinical indications to radiation oncology, technical issues of radiation oncology (target volumes delineation by primary site and tecniques)
Session 5: In room imaging guided radiotherapy
Drill and practice exercises in small working groups on how to determine PTV margin, and IGRT by portal imaging and CT cone beam will favour discussion on daily dose delivery issues.
Session 6: Gastric
Take-home messages lectures about incidence rates for local recurrence; imaging based staging and radiological anatomy; surgery, medical oncology, clinical indications and technical issues of radiation oncology
Session 7: Refresh Lectures
Preoperative approach to Gastric cancer; SBRT for pancreatic cancer; Long course Radiotherapy for pancreatic cancer; HCC; Intrahepatic bliar tract cancer; Extrahepatic bliar tract cancer; Cervical Esophageal cancer; Ongoing trials
Before commencing this course, participants should have practiced upper GI cancer:
• Tumour board discussion
• Planning optimisation and comparison
• Outcome monitoring.
• Interactive sessions
• Small working groups
• Individual practice.
Methods of Assessment
• Small working groups with experts
• On site Survey Monkey